Use of Endobronchial Ultrasound Guided Mediastinal Cryobiopsy in Addition to Endobronchial Ultrasound Guided Transbronchial Needle Aspiration and Rapid on Site Evaluation for Evaluation of Enlarged Mediastinal Nodes ( Case series )

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS- TBNA) with rapid on site evaluation (ROSE) has been used worldwide in the diagnosis of enlarged mediastinal nodes, with minimally invasive techniques, for many years. With recent advances in the genetic study of cancer, in order to determine the appropriate chemotherapy for cancer, more tissue samples need to be studied, and the amount of tissue obtained via EBUS-TBNA may not be adequate in patients with cancer, lymphoma and sarcoidosis. Recently it has been found that the technique of EBUS-guided mediastinal cryobiopsy (EBUS-MCB) may provide an adequate tissue amount for study with minimal invasiveness and performed safely. We reported 3 cases of enlarged mediastinal nodes, using EBUS-TBNA, and ROSE, and EBUS-MCB in an additional 2 cases. EBUS-MCB provided additional information in 1 case, and confirmation in 1 case. EBUS-MCB is a useful tool to supplement EBUS-TBNA and ROSE in the investigation of enlarged mediastinal nodes.